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Meta-Analysis
. 2020 Jan 20;20(1):16.
doi: 10.1186/s12876-020-1167-x.

The prognostic role of platelet-to-lymphocyte ratio on overall survival in gastric cancer: a systematic review and meta-analysis

Weijuan Cao  1 , Xiaomin Yao  1 , Danwei Cen  1 , Yajun Zhi  1 , Ningwei Zhu  1 , Liyong Xu  2
Affiliations
Meta-Analysis

The prognostic role of platelet-to-lymphocyte ratio on overall survival in gastric cancer: a systematic review and meta-analysis

Weijuan Cao et al. BMC Gastroenterol. .

Abstract

Background: This study aimed to summarize the previously published literature on the role of platelet-to-lymphocyte ratio (PLR) on overall survival (OS) in patients with gastric cancer.

Methods: We systematically searched PubMed, EmBase, and the Cochrane library to identify eligible studies to review. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model. Sensitivity and subgroup analyses were performed, and publication bias was assessed.

Results: A total of 28 studies comprising 15,617 patients with gastric cancer were included in this meta-analysis. The pooled results indicated that elevated PLR was associated with poor OS (HR: 1.37; 95% CI: 1.24-1.51; P < 0.001). A significant publication bias was observed (Egger test, P = 0.036; Begg test, P = 0.017). After adjusting for publication bias using the trim and fill method, an adjusted pooled HR of 1.19 (95% CI: 1.08-1.33; P = 0.001) was observed. Subgroup analyses indicated an elevated PLR in retrospective studies. Studies conducted in Turkey, the UK, the USA, and Costa Rica; studies with a sample size of < 1000, with < 70% male patients, and with patients treated with chemotherapy; studies with PLR cutoff value of ≥200; and studies with lower quality as determined by the Newcastle-Ottawa Scale all showed greater harmful effects on OS than their corresponding subsets (P < 0.05).

Conclusions: An elevated PLR was associated with poor OS in patients with gastric cancer. These results might differ between studies due to differences in design, country of origin, sample size, sex proportion, treatment strategy, PLR cutoff value, and study quality.

Keywords: Blood platelets; Lymphocyte count; Meta-analysis; Prognosis; Stomach neoplasms.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
A flow diagram of the literature search and trials selection process
Fig. 2
Fig. 2
The prognostic role of PLR on OS in gastric cancer patients
Fig. 3
Fig. 3
Publication bias for the prognostic role of PLR on OS in gastric cancer patients
Fig. 4
Fig. 4
The pooled result adjusted by the trim and fill method
See this image and copyright information in PMC

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